ATI RN
ATI Pediatric Proctored Exam 2023
1. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?
- A. Massive proteinuria, hypoalbuminemia, and edema
- B. Hematuria, bacteriuria, and weight gain
- C. Decreased urine specific gravity and increased urinary output
- D. Gross hematuria, albuminuria, and fever
Correct answer: A
Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.
2. Which statement is true regarding playful children?
- A. They exhibit flexible problem-solving.
- B. They have low intelligence scores.
- C. They need clear rules and directions to succeed.
- D. They do not perform well in school.
Correct answer: A
Rationale: The correct statement is that playful children exhibit flexible problem-solving. Playful children often engage in creative and imaginative thinking, allowing them to approach problems in unique ways. This fosters better problem-solving abilities compared to those who may be more rigid in their thinking. Choice B is incorrect as there is no direct correlation between being playful and having low intelligence scores. Choice C is incorrect as playful children may thrive in environments that encourage creativity rather than rigid rules. Choice D is incorrect as being playful does not necessarily equate to poor academic performance.
3. The healthcare provider is providing care to a child who was treated with aspirin during a viral infection. Which clinical manifestations should cause the healthcare provider concern?
- A. Nausea, vomiting, and confusion
- B. Headache, vomiting, and seizures
- C. Sore throat, moist respirations, and cough
- D. Fever, rash, and photophobia
Correct answer: A
Rationale: The symptoms of nausea, vomiting, and confusion are concerning as they are indicative of Reye's syndrome, a rare but serious condition associated with aspirin use in children during viral illnesses. Reye's syndrome can lead to severe complications, including brain and liver damage, hence prompt recognition and management are crucial.
4. When planning care for a pediatric client diagnosed with bacterial meningitis, what is the priority nursing diagnosis?
- A. Impaired Gas Exchange
- B. Risk for Infection
- C. Anxiety (parental)
- D. Acute Pain
Correct answer: A
Rationale: The priority nursing diagnosis when caring for a pediatric client with bacterial meningitis is 'Impaired Gas Exchange.' This diagnosis takes precedence due to the potential for respiratory complications associated with the condition. Bacterial meningitis can lead to increased intracranial pressure, compromising the child's ability to ventilate adequately. Therefore, monitoring and addressing any signs of respiratory distress are crucial in the care of these patients.
5. A child with nephrotic syndrome has not experienced diuresis after a month on corticosteroids. What protocol can the nurse encourage to induce diuresis?
- A. Ibuprofen, an anti-inflammatory agent
- B. Furosemide (Lasix), a diuretic
- C. Ciprofloxacin (Cipro), an antibiotic
- D. Cyclophosphamide (Cytoxan), an immunosuppressant
Correct answer: B
Rationale: To induce diuresis in a child with nephrotic syndrome who has not responded to corticosteroids, a diuretic like Furosemide (Lasix) is appropriate. Furosemide helps increase urine production and reduce fluid retention. Ibuprofen is an anti-inflammatory agent and does not directly induce diuresis. Ciprofloxacin is an antibiotic and is not used to promote diuresis. Cyclophosphamide is an immunosuppressant, not an antisuppressant, and is not typically used to induce diuresis in nephrotic syndrome.
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